{"id":3554,"date":"2026-07-31T16:15:12","date_gmt":"2026-07-31T14:15:12","guid":{"rendered":"https:\/\/www.first-sight.ch\/?post_type=glossary&#038;p=3554"},"modified":"2026-07-31T16:16:53","modified_gmt":"2026-07-31T14:16:53","slug":"idiopathic-intracranial-hypertension-pseudotumor-cerebri","status":"publish","type":"glossary","link":"https:\/\/www.first-sight.ch\/en\/glossar\/idiopathic-intracranial-hypertension-pseudotumor-cerebri\/","title":{"rendered":"Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)"},"content":{"rendered":"<p>Idiopathic intracranial hypertension (IIH), formerly known as pseudotumor cerebri, is a condition in which the pressure of the cerebrospinal fluid (CSF) is raised without a tumor or another structural cause being present. Although IIH is not a cancer, the chronically raised intracranial pressure can seriously endanger vision if it is not treated in time.<\/p>\n<h2>Who does IIH affect?<\/h2>\n<p>IIH occurs most often in women of childbearing age, but it can also affect children and men. Being overweight is the most important risk factor. In children before puberty, the distribution between the sexes is more balanced, but in overweight adolescents it is similar to adults.<\/p>\n<p>Other possible risk factors:<\/p>\n<ul>\n<li>Certain medications (e.g. tetracyclines, vitamin A preparations, growth hormones, corticosteroids after discontinuation)<\/li>\n<li>Hormonal changes<\/li>\n<li>Sleep apnea<\/li>\n<li>Anemia<\/li>\n<\/ul>\n<h2>Symptoms<\/h2>\n<ul>\n<li><strong>Headaches:<\/strong> often the first and most striking symptom. The headaches are frequently severe, present daily, and can worsen with coughing, straining, or changes in position.<\/li>\n<li><strong>Pulsating ear noise (pulsatile tinnitus):<\/strong> a rhythmic whooshing that matches the heartbeat.<\/li>\n<li><strong>Transient visual obscurations:<\/strong> brief graying or blacking out of vision, often when standing up or bending over.<\/li>\n<li><strong><a href=\"https:\/\/www.first-sight.ch\/en\/glossar\/double-vision\/\">Double vision<\/a>:<\/strong> pressure on the sixth cranial nerve can cause horizontal double vision.<\/li>\n<li><strong>Visual field defects:<\/strong> enlargement of the blind spot and peripheral visual field loss, which can initially go unnoticed.<\/li>\n<li><strong>In severe cases:<\/strong> declining visual acuity and disturbances of color vision.<\/li>\n<\/ul>\n<h2>Diagnosis<\/h2>\n<p>IIH is diagnosed in several steps:<\/p>\n<ul>\n<li><strong>Eye examination:<\/strong> the slit lamp and fundus examination reveal swelling of the optic disc (papilledema). A visual field test documents any defects.<\/li>\n<li><strong>Imaging (MRI\/MRV):<\/strong> to rule out tumors, vascular occlusions, and other structural causes. Typical IIH signs may be visible on MRI (e.g. empty sella, dilated optic nerve sheaths).<\/li>\n<li><strong>Lumbar puncture:<\/strong> measuring the CSF pressure confirms the diagnosis. A raised opening pressure with a normal CSF result is characteristic.<\/li>\n<\/ul>\n<h2>Treatment<\/h2>\n<h3>Weight reduction<\/h3>\n<p>In overweight patients, weight loss is the most effective long-term treatment. Even a moderate reduction in weight can significantly lower the intracranial pressure.<\/p>\n<h3>Drug therapy<\/h3>\n<ul>\n<li><strong>Acetazolamide (Diamox):<\/strong> the most commonly used medication. It reduces CSF production and thereby lowers the intracranial pressure.<\/li>\n<li><strong>Furosemide:<\/strong> can be used in addition or as an alternative.<\/li>\n<li><strong>Topiramate:<\/strong> is sometimes used because it can lower the intracranial pressure and also reduce headaches and weight.<\/li>\n<\/ul>\n<h3>Surgical options<\/h3>\n<p>If vision deteriorates rapidly or drug therapy fails, surgical procedures are available:<\/p>\n<ul>\n<li><strong>Optic nerve sheath fenestration:<\/strong> small openings in the sheath of the optic nerve relieve the pressure directly at the nerve.<\/li>\n<li><strong>CSF shunt:<\/strong> a thin tube drains excess cerebrospinal fluid (lumboperitoneal or ventriculoperitoneal).<\/li>\n<li><strong>Venous sinus stenting:<\/strong> in selected cases, a narrowing of the brain veins (sinus stenosis) can be treated with a stent.<\/li>\n<\/ul>\n<h2>Why is ophthalmological care so important?<\/h2>\n<p>The most dangerous aspect of IIH is the gradual, often unnoticed loss of vision. About 10% of patients suffer permanent visual damage. Regular <a href=\"https:\/\/www.first-sight.ch\/en\/angebot\/eye-examination-ophthalmologist\/\">ophthalmological check-ups<\/a> with visual field testing and assessment of the optic disc are therefore essential to adjust treatment in time.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Idiopathic intracranial hypertension (IIH), formerly known as pseudotumor cerebri, is a condition in which the pressure of the cerebrospinal fluid (CSF) is raised without a tumor or another structural cause being present. Although IIH is not a cancer, the chronically raised intracranial pressure can seriously endanger vision if it is not treated in time. Who [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"_wpce_doc":"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